Claims Detail Screen
Locate the terms found in the claims detail screen.
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BRAND-NAME
DATE-OF-SERVICE
DATE-SUBMITTED
DAW-CODE
DAY-SUPPLY
DEA-CLASS
GENERIC-INDICATOR
GENERIC-NAME
GPI
MANUFACTURER
NABP
NDC
NPI
PRESCRIBER-ID
PRESCRIBER-NAME
PROVIDER-NAME
QUANTITY-DIPENSED
REJECTION-CODE
REJECTION-MESSAGE
REMAININGTROOP
RX-NUMBER
N | D | T | Z | D | E | T | T | I | M | B | U | S | - | E | T | A | D | B | A |
X | A | A | P | E | D | A | T | E | - | O | F | - | S | E | R | V | I | C | E |
L | V | Q | C | A | E | G | E | M | A | N | - | C | I | R | E | N | E | G | T |
G | P | K | N | - | S | H | T | M | N | G | S | C | D | F | Q | W | E | Y | B |
H | Q | B | P | C | N | X | V | L | Z | G | F | Q | P | B | A | N | D | C | R |
X | R | P | R | L | E | D | O | C | - | W | A | D | E | P | E | H | X | Q | V |
M | Q | O | E | A | P | R | E | S | C | R | I | B | E | R | - | N | A | M | E |
A | G | O | S | S | I | E | D | O | C | - | N | O | I | T | C | E | J | E | R |
N | O | R | C | S | D | D | Z | D | L | L | J | C | V | V | T | W | X | Y | X |
U | G | T | R | S | - | B | I | K | A | D | - | G | G | I | O | A | B | X | - |
F | S | G | I | S | Y | Y | Q | P | X | I | S | L | J | M | D | A | F | S | N |
A | P | N | B | E | T | E | M | A | N | - | R | E | D | I | V | O | R | P | U |
C | Z | I | E | V | I | G | Q | D | A | Y | - | S | U | P | P | L | Y | A | M |
T | Q | N | R | H | T | K | I | D | U | T | P | D | K | R | V | S | O | U | B |
U | K | I | - | O | N | C | B | Z | G | P | X | S | V | J | F | B | S | V | E |
R | O | A | I | F | A | G | M | O | C | X | Q | A | A | B | W | U | M | Z | R |
E | Q | M | D | T | U | Q | J | M | P | G | I | Y | W | N | O | K | X | J | I |
R | N | E | O | A | Q | B | G | E | M | A | N | - | D | N | A | R | B | P | L |
J | C | R | E | J | E | C | T | I | O | N | - | M | E | S | S | A | G | E | W |
M | W | C | Y | Z | H | M | N | J | R | B | Y | S | Q | V | I | N | R | B | Q |
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